Anti-Müllerian hormone as a marker of ovarian reserve in patients with ovarian malignancies who have undergone fertility-preserving surgery and chemotherapy

Abstract

With proper and careful selection of patients, fertility-preserving surgery may be feasible in patients with ovarian malignancies. However, the loss of follicles by oophorectomy and chemotherapy results in decreased ovarian reserve, which consecutively affects reproductive capacity. We evaluated postoperative levels of serum anti-Müllerian hormone (AMH) in women with ovarian malignancies to assess the impact of the fertility-preserving surgery with or without the administration of chemotherapy on ovarian reserve. In 13 patients who underwent the fertility-preserving surgery with (n = 9) or without (n = 4) the administration of chemotherapy, serum AMH levels were measured and compared with serum AMH levels measured in patients undergone cystectomy for benign ovarian tumors as a control. We found that the mean AMH level in the treatment group measured 0.9 ng/mL, which was significantly lower than that measured in the control group (4.70 ± 3.77 ng/mL). The possibility of decreased ovarian reserve occurring in patients with ovarian malignancies following treatment with fertility-preserving surgery with or without the administration of chemotherapy should be considered for fertility planning.

The clinical utility of serum anti‐Müllerian hormone in the follow‐up of ovarian adult‐type granulosa cell tumors—A comparative study with inhibin B

“…As regards the clinical cutoff values of AMH in AGCT patient follow‐up, serum AMH levels should be undetectable in postmenopausal women. In premenopausal patients, however, the clinical cutoff should be evaluated individually due to the facts that AMH levels decrease with age, and after unilateral oophorectomy . Consistently, individual patients with rising AMH values during follow‐up should be closely monitored for disease progression.…”

Clinical application of serum anti‐Müllerian hormone as an ovarian reserve marker: A review of recent studies

“…Except for infertility treatments, a decreased ovarian reserve in childhood cancer survivors was the first published clinical implication of serum AMH . Since then, many studies have been published in which serum AMH was adopted to assess ovarian reserve after chemotherapy for diseases such as breast cancer, hematological malignancies, sarcomas and gynecological malignancies . Serum AMH is becoming a helpful tool for counseling women undergoing chemotherapy who desire future fertility, including fertility preservation .…”

Tumeurs épithéliales de l’ovaire : préservation de la fertilité. Article rédigé sur la base de la recommandation nationale de bonnes pratiques cliniques en cancérologie intitulée « Conduites à tenir initiales devant des patientes atteintes d’un cancer épithélial de l’ovaire » élaborée par FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY sous l’égide du CNGOF et labellisée par l’INCa

“…Le dosage de l'AMH est un marqueur utilisable pour é valuer de façon quantitative la ré serve ovarienne chez une femme en vue de cryoconservation de gamè tes [27]. Le travail d'Iwase et al [28] avait comparé 13 patientes ayant bé né ficié d'une chirurgie conservatrice pour carcinome é pithé lial de l'ovaire dont 9 avaient reçu une chimiothé rapie, à une population de femmes ayant bé né ficié d'une kystectomie ovarienne. Dans cette sé rie trè s limité e, il avait montré des taux significativement abaissé s d'AMH chez les femmes ayant reçu une chimiothé rapie (NP4).…”